NHS Waiting Times: Long-Term Sickness Absence

Lord Evans of Rainow Excerpts

Thursday 19th October 2023 Lords Chamber

[Baroness Merron]

To ask His Majesty’s Government what recent assessment they have made of the impact of NHS waiting times on the number of people off work due to long-term sickness.

[Lord Evans of Rainow (Con)]

My Lords, I first pay tribute to the noble Baroness for her work on the Board of Deputies of British Jews at this very difficult time. We are very lucky to have her in this place.

Cutting waiting lists is one of the Government’s top priorities. We consistently assess the size of waiting lists and progress in reducing long waits. We are delivering our elective recovery plan and have virtually eliminated two-year and 18-month waits. The most clinically urgent patients continue to be treated first. We are working with the Department for Work and Pensions to understand and explore solutions to the impact of elective waits on economic inactivity.

[Baroness Merron (Lab)]

Before responding on the Question, I thank the Minister for his kindness, his generous comment and his support for the Jewish community and others at this time.

An all-time high of more than 2.6 million people do not have jobs because of ill health, including long Covid, while the CQC has found that two in five people admitted to hospital for planned care had their health worsen while they were on the waiting list. So does the Minister accept that ever-lengthening waiting lists and difficulties in accessing treatment are affecting people’s livelihoods as well as the economy? How do the Government plan to address this?

--- Later in debate ---

[Lord Evans of Rainow (Con)]

My Lords, the noble Baroness is exactly right: a healthier population is also a wealthier and more productive one. This Government are committed to supporting people with health conditions to start, stay and succeed in work. The NHS is working incredibly hard to ensure that those who have been waiting the longest receive treatment as soon as possible to ensure that people get the right care at the right time. That is why we are delivering record staffing numbers and putting in record levels of funding to help the NHS recover and transform services. The elective recovery plan set clear ambitions to eliminate long waits for planned NHS treatments.

[Lord Forsyth of Drumlean (Con)]

My Lords, people with private health insurance are able to get almost immediate treatment, including diagnostic and other treatment, so why do the Government not use the private sector to reduce these waiting lists and reboot our economy?

[Lord Evans of Rainow (Con)]

My Lords, the NHS does use the private sector where appropriate—

[Lord Forsyth of Drumlean (Con)]

Not enough.

[Lord Evans of Rainow (Con)]

My noble friend says, “Not enough”, but wherever we can utilise other sectors, such as the private sector, we do so—but there is clearly more to be done.

[Lord Allan of Hallam (LD)]

My Lords, the most common conditions that lead to economic inactivity are mental health conditions such as depression and acute anxiety. What are the Government doing to get on top of wait times for therapies that will help people with these kinds of mental health conditions? In particular, what are they doing to address the significant inequalities across the country, which mean that people in some places can get talking therapies quickly, while in other places they are left waiting for many months?

[Lord Evans of Rainow (Con)]

The noble Lord asks a good question; however, it is not just mental health but also other things, such as musculoskeletal and cardiovascular disease, so the whole thing has to be done at the same time. But, on the disparity of the service, the noble Lord raised a good point, and I have said before from this Dispatch Box that more has to be done to share best practice across NHS England.

[Baroness Blackstone (Lab)]

My Lords, I declare my interests as listed in the register. Some 600,000 women are waiting for gynaecological surgery, and many of them report that they are either unable to work at all or their work is seriously disrupted by their conditions. Given the disproportionate increase in waiting-list numbers for gynaecological surgery, can the Minister tell the House what priority the Government are giving to addressing this problem?

[Lord Evans of Rainow (Con)]

The Government plan to spend £8 billion in revenue funding and make a £5.9 billion investment in NHS capital projects, which will include new hubs that will do diagnosis and, hopefully, will allow the people she mentioned to get a speedier diagnosis and, therefore, speedier treatment.

[Baroness Hollins (CB)]

My Lords, the Minister suggested that musculoskeletal conditions were of equal concern to mental health conditions, but many people with musculoskeletal conditions also have mental health conditions, which are often hidden. Is anything being done to try to reach parity of esteem for mental health with physical health, as was promised in the Health and Social Care Act 2012?

[Lord Evans of Rainow (Con)]

The noble Baroness raises a good point. The Government have announced a health package of £400 million, to be focused specifically on mental health, musculoskeletal problems and the cardiovascular system. A package of digital tools for mental health and MSK, worth £225 million, is expected to be delivered during 2023-24. There is still a lot to be done, but a lot of good work is going on in the pipeline, and I hope noble Lords will see that filter through shortly.

[Baroness Manzoor (Con)]

My Lords, if you cannot get a GP appointment, you are more likely to be off work for longer. In some parts of the country, one in five people are waiting for over a month, and the NHS data shows that 50% of people are waiting for 48 hours, which is compounding problems with returning to work. Can my noble friend the Minister say what the Government are doing to address this?

[Lord Evans of Rainow (Con)]

My noble friend raises an important point. The first port of call for the vast majority of citizens in this country is their GP practice, to enable them to be diagnosed and, therefore, forwarded to the relevant NHS services. The Government work closely with GP practices to encourage them to improve the way they communicate with their patients, but there is clearly more to be done.

[The Lord Bishop of Southwell and Nottingham]

My Lords, the delays in treatment for long-term sickness do not just affect those returning to work but have a secondary impact on family life. Have the Government assessed the effect of these delays on children and young people under 18, who frequently take on additional caring responsibilities for parents with long-term sickness, although this is often detrimental to their education and their emotional and mental health?

[Lord Evans of Rainow (Con)]

The Government do not have a specific analysis in my pack here, but the right reverend Prelate is absolutely right. This is important for children and young people growing up in households where both parents work, and, if that does not happen for whatever reason, it can have a significant effect on those young carers. So the right reverend Prelate is absolutely right to bring this up, but I cannot give him a full answer and will write to him.

[Lord Kakkar (CB)]

My Lords, I draw noble Lords’ attention to my registered interests. While patients with chronic conditions wait for intervention, there is inevitable disease progression. Have His Majesty’s Government been able to make an assessment of the impact on the ultimate clinical outcome of these delays, as a result of disease progressing?

[Lord Evans of Rainow (Con)]

I am sorry, but I do not have a specific answer to that precise question, so I will write to the noble Lord in detail. He raises an important point: obviously, being on the waiting list for a long time is not good from the point of view of pain and a general deterioration in health.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, to take the noble Lord back to the question about GPs, clearly there is an extensive capacity issue with GP services across the country, but would the noble Lord not agree that there is also now a structural problem in the relationship between primary and secondary care? One of the impacts of this is that, partly for capacity and partly for structural reasons, GPs default to sending people to A&E, which builds up the pressure in hospitals. How are the Government looking at that relationship between primary and secondary care to see whether we can get back to something that looks a bit more like a joined-up system?

[Lord Evans of Rainow (Con)]

The noble Baroness raises an important point. One of the issues is best practice: some GP practices engage through social media and other electronic internet-based systems where you can book appointments, but, sadly, some others are still unable to do that. For example, in some, the only way you can get an appointment is by phoning between 8 am and 10 am and, if they are booked up, you have to wait until the following day—but they do not tell you that that is the only time you can call. So GP practices can clearly do more to interface with their patients. There are some outstanding examples, but, unfortunately, there is still a lot more to do on that.

[Lord Shinkwin (Con)]

My Lords, one of the key aims of the Sunday Express’s Better Bones campaign, in collaboration with the Royal Osteoporosis Society, for £30 million extra funding for fracture liaison services is reducing the 1.9 million work days currently lost through fractures. Can I ask my noble friend if he might just point out to the Chancellor, in advance of the Autumn Statement, that that investment would be money very well spent?

[Lord Evans of Rainow (Con)]

I am most grateful to my noble friend for his work on this subject. It is funny that he should mention this because on my desk I have a big pack on exactly that point, which has just been delivered. I happy to do as he asks.